Screening

Your Organisational Guidance

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Diabetes Mellitus Type 2Published by: Domus Medica | SSMGLast published: 2017Diabète sucré de type 2Published by: SSMG | Domus MedicaLast published: 2017

There is no routine population-level screening for type 2 diabetes in the UK.[100]

The National Institute for Health and Care Excellence (NICE) in the UK recommends a two-stage strategy to identify people at high risk of type 2 diabetes and those with undiagnosed type 2 diabetes: a risk assessment and, if necessary, a confirmatory blood test.[27] NICE recommends that general practitioners (primary care physicians) use a validated computer-based risk-assessment tool to identify people on their practice register who may be at high risk of type 2 diabetes.[27] In addition, it recommends that pharmacists, opticians, occupational health nurses, and community leaders should offer a validated self-assessment questionnaire or validated web-based tools to:[27] 

  • All adults aged 40 years and above (except pregnant women)

  • People aged 25-39 years of South Asian, Chinese, African-Caribbean, and black African ethnicity (except pregnant women)

  • Adults with any other condition that increases the risk of type 2 diabetes.

Those with a high risk score should be advised to contact their GP or practice nurse for a fasting plasma glucose or HbA1c test; a blood test should also be considered regardless of risk score for those aged 25 years and over of South Asian or Chinese descent whose body mass index (BMI) is greater than 23 kg/m².[27] 

People identified as being at high risk of progression to type 2 diabetes, that is, having non-diabetic hyperglycaemia, NDH (defined as fasting plasma glucose of 5.5 to 6.9 mmol/L [99.0 to 124.2 mg/dL] or HbA1c of 42 to 47 mmol/mol [6.0% to 6.4%]), should be offered a referral to an evidence-based, quality-assured intensive lifestyle-change programme.[27]

In England, one such programme is the NHS Diabetes Prevention Programme (DPP), also called the ‘Healthier You’ programme.[44]​ It identifies people at risk of developing type 2 diabetes and enrolls them onto a 9-month, evidence-based, personalised lifestyle change programme, which is available as a face-to-face group service or as a digital service.[44]

While the UK does not have a population-wide national screening programme, some other countries do. For example, in the US:

  • The US Preventive Services Task Force recommends screening for glucose status for adults aged 35-70 years who have BMI ≥25 kg/m²[101]

  • The American Diabetes Association recommends routine screening of non-pregnant asymptomatic adults of any age with BMI ≥25 kg/m² (≥23 kg/m² for people of Asian descent) plus one or more additional risk factors for diabetes.​[34]

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